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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198603437
Report Date: 07/03/2023
Date Signed: 07/03/2023 04:05:53 PM

Document Has Been Signed on 07/03/2023 04:05 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME:EASTER SEALS SOUTHERN CALIFORNIA INC.FACILITY NUMBER:
198603437
ADMINISTRATOR:BELLARD, LATASHAFACILITY TYPE:
775
ADDRESS:10358 ARTESIA BLVD.TELEPHONE:
(310) 882-8498
CITY:BELLFLOWERSTATE: CAZIP CODE:
90706
CAPACITY: 40CENSUS: 40DATE:
07/03/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:34 PM
MET WITH:LaTasha Bellard - Program DirectorTIME COMPLETED:
04:03 PM
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Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced annual inspection. LPA Pena was met by the Program Director, LaTasha Bellard and explained the purpose of today's visit. The facility is a freestanding building, an office type property within the city of Bellflower. It is licensed to serve clients age range 18 and over, 40 ambulatory, of which 25 may be non-ambulatory. All clients at the program receive case management services provided by Harbor Regional Center. The day program consists of a lobby area, living room, participant storage lockers, activity rooms, three (3) client restrooms, one of which is an all-gender restroom, storage rooms, chemical room, relaxing/meditation room, media room, computer lab room, break room, patio and staff offices. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and the following was inspected:

Physical Plant & Environment Safety:

  • The program site has a universal screening area located in the entrance.
  • There was COVID-19 signage placed at the entrance door.
  • Smoke detectors/carbon monoxide detectors are centralized and were in compliance and operational.
  • The program site has fire pull alarms.
  • The program site is equipped with a centralized sprinkler system.
  • The program site maintained a 30-day supply of PPEs such as masks, gloves, hand sanitizers and gowns.
  • There are fifteen (15) lockers available for clients use, located in the staff break room.
  • The program site provides media room and computer room for clients' use.
  • There is a relaxation room for rest periods available to clients and staff which also serves as first-aid treatment room.
  • Cleaning supplies and other toxic materials were separate from where food supplies are stored. It is stored and kept locked in the chemical room.
  • There is a supply/storage room to house the PPE supplies which was locked and inaccessible to clients.
  • Hot water temperature was measured in the kitchen and read at 111.2 which was within the required 105-120 degrees F.
  • Bathrooms have touchless faucets which deliver hot water and measured within the required 105-120 deg F.
  • A fire extinguisher was observed in the kitchen to be fully charged and last serviced on January 27, 2023.
  • LPA observed sharp objects in a locked cabinet located in one of the staff office.
  • Doors, exits, hallways, and passageways were clear and free of obstruction.
  • The front yard/parking area was observed to be clean and free of debris.
  • No pools or bodies of water were observed in or around the building.
  • There are no firearms present at the facility.
  • The program site has a video camera monitor system outside the building. There are no cameras inside.

***CONTINUED ON LIC 809-C*****
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Bennette Pena
LICENSING EVALUATOR SIGNATURE: DATE: 07/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/03/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: EASTER SEALS SOUTHERN CALIFORNIA INC.
FACILITY NUMBER: 198603437
VISIT DATE: 07/03/2023
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Operational Requirements:
  • A current Plan of Operation was reviewed. The Infection Control Plan has been added to the Plan.
  • The facility has a fire clearance from the Fire Department Eastern Region Cerritos Office for a capacity of forty (4) ambulatory of which 25 may be non-ambulatory.
  • Liability Insurance is in place.
  • The program has a computer room, and provides three (3) computers for clients use.
  • The program site does not handle clients' cash resources.
  • Four (4) operating telephones were observed and are easily accessible and available for clients' use.
Personnel Records-Training:
  • Criminal Record clearances/exemptions are maintained at the program site.
  • Client files were inspected and emergency contact information and health screenings were updated.
  • Staff files were inspected and contained required criminal record background checks, health screenings, TB test, and First-Aid/CPR.
  • A plan of coverage in absence of the Program Director is in place, the Program Supervisor will step-in her absence, and vice versa.
Client Rights-Information:
  • The program site has adequate furnishings and equipment to meet the clients' needs.
  • Visitors policy was observed posted in the workspace area accessible to clients and their visitors.
Food Service:
  • This day program does not serve meals but clients are welcome to bring their own lunch and warm the food in the kitchen if they prefer.
  • Food storage and preparation areas, which include pantries, cupboards, drawers and counters were observed to be clean and appropriate for food preparation. Appliances such as a microwave, refrigerator and stove were observed to be clean and operating properly.
  • The program runs once daily for 5 hours.
  • The refrigerator was observed to be at 45 degrees Fahrenheit and the freezer at 0 degrees Fahrenheit.
Health Related Services:
  • First Aid supply was observed and is kept in a locked cabinet in the kitchen area which included all required supplies.
  • List of emergency contacts such as Police, Fire Dept. or paramedic unit was reviewed. The program site has one medical resource available to be called at all times.
  • Medications was observed stored and locked in the Staff office.
Disaster Preparedness:
  • The facility has a complete Emergency and Disaster Preparedness Plan that includes, EVAC Procedures, Transportation arrangements, Location of all utility shut-off valves and instructions for use.
  • The program has a contact information list of local emergency response personnel, clients authorized representative or local emergency contact name.


Exit interview conducted and a copy of this report was provided to the Program Director, LaTasha Bellard.
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Bennette Pena
LICENSING EVALUATOR SIGNATURE:

DATE: 07/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2023
LIC809 (FAS) - (06/04)
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